A Work in Progress

I started out Monday morning so early that sleeping in until 7 the next day sounded awesome. As I was driving along to this far away clinical, the sun was coming up, the road signs became keystone shaped, and all I could think was “why are there so many people driving at this unholy hour?” It was like a mini road trip except too short to stop and eat, too early or too late to do something impulsive and fun, and I was by myself. The clinical itself was pretty good. The ‘white cloud’ gods didn’t realize I was there until about 10 am, so I got to run a few calls before they stopped coming in completely. I was on an ALS chase car, hospital based system. Upgrading to ALS is nice as the patient is usually already packaged, and histories, allergies, and med lists are already obtained, sweet! We had an asthma attack and a guy who ate a whole bottle of vicodin. The preceptors there are pretty cool as they really do sit back and let you go at it, intervening only if you’re about to kill the pati...

I received my first application for a real job, yikes! This whole real life thing is beginning to freak me out. So far, this is the only company that interests me. To get the job I have to (finish school, get my registry paramedic) apply, take tests etc. Then, if I get it, I have to find a place to live, get reciprocity, probably get a new car, ride 20 shifts before I get cut loose, and oh yeah, this is over 400 miles from home. Don’t tell anyone, but I’m scared. I got cleared at work, yay! (not a fake job per se, but...) Last week, I spent 12 hours of clinical time doing BLS calls, (not that they can’t be useful in some way…wait. what am I saying?) One was a call for a stroke. “Awesome!” says I, anticipating a good ALS call to salvage the day. 5 seconds after we arrived, it became clear that it was not a stroke, heart attack, dismemberment, asthma attack, or fainting; but actually absolutely nothing. Medic: What’s going on that makes you think you’re having a stro...

That (with an open mouthed stare) about sums up my emotions concerning the few patients that I saw during my observation rotation at the premier trauma center in the country. I was told that they often inadvertently have ‘theme nights.’ The night I was there, the theme definitely would have been: Faces. I will spare you from the gory details by using medical terms and other big words. Patient #1: His cerebrum came in contact with a small lead projectile, forcing it to leave the skull permanently. Patient #2: Patient’s frontal lobe was herniating into the orbits. I’ll leave that one to the imagination. Patient #3: Prisoner was stabbed with a bucket handle resulting in a tension pneumothorax. Patient #4: Patient’s face came in contact with a human fist at a high velocity. Patient #5: Defenestrated herself from the second story of a burning building, resulting in the avulsion of the lower 2/3 of her face. If all of these patients had actually only been one ...

Ah, the Harry Potter franchise. I love it. The latest installment in cinema form came out yesterday. I really liked this ‘cliff notes’ version of the book. Granted, I could go on for days about what was missing or changed. And, I believe that people who have not read the books will be pretty lost by the end, it’s book readers movie. I do think that the producers underestimate the attention span of Potter fans. We can follow a scene with more than six lines in it. We can be entertained by scenes without extra dragon time. I love the story for the story; the action is just a bonus. In general: the world cup is short, the challenges have the best effects yet, Rita is hilarious, the acting is better than ever, the Yule Ball is a consummate representation of teen angst, and “He-who-must-not-be-named” is deliciously creepy.

Wednesday was a work day. I got paid mostly to read Harry Potter and JEMS, sweet! We only ran three calls, and one of those was BLS anyway, requiring more muscles than brain cells. The other two calls were pretty good. I felt slightly less retarded running them today as opposed to my last shift. Yesterday I ran with a critical care transport team. My first call was a guy who had a lung transplant last month, and it wasn’t going well. We took him from his bed in ICU to get a lung biopsy. That was pretty cool. First and foremost, I got to wear a lead apron; that was pretty hardcore (and heavy!) Then they used a bronchoscope to go down his ET tube and into his lungs, where we could see the sutures from his lung transplant. After taking some pictures and performing lavage (which consisted of them injecting saline into his lungs and sucking it back out) they stuck a smaller tube in that went deeper than the scope. This tube had a little claw-type thing on it that open up and grabbed some lu...

After an uneventful weekend, aside from getting to hang out with my niece and nephews, today I returned to the illustrious city. If it hadn’t been for said relatives, the weekend may have been a complete loss. Yes, I did have a helicopter shift. We did get to fly to another hangar for maintenance. Other than that, I did some homework, got pretty far into my ‘remind me what happened’ reading of Harry Potter 4, and even watched an entire football game. That should show you how bored I was. A visiting boy scout troop broke up the monotony of the day, a bit. But, back to today. Because I have been one of the lucky few to not be assigned a city preceptor yet, I’ll be borrowing everyone else’s. I rode today with a supervisor truck which was pretty cool. Basically we rode around and squirreled calls that sounded interesting. I was reminded of how much I enjoyed my city shifts last year. We had a heroin overdose who ‘got distracted’ on the way to rehab, a fender bender, twins ready to be born...

Wednesday I had my first shift in a neighboring Maryland county. It was really nice. We had two chest pains in a row and later in the day we had a cardiac arrest in a nursing home. It wasn’t dispatched as such so we brought in the traditional ‘baggage.’ As we went down the hall, all of the employees simply looked at us and then pointed in the general direction of the room. Every single employee, not excitedly, but quietly pointed. We were almost to the room when I thought to myself, we should have brought the monitor. We found the patient conveniently placed right behind the room door with CPR in progress. He should have been suctioned probably 10 minutes before we got there, but alas. We took over, I put him on the monitor and my preceptor went for the tube. I was initially jealous of his position (it was merely more convenient in that ridiculous space in which we had to work for him to attempt the tube) but my jealousy quickly dissipated when what looked to be an easy tub...

I had my first helicopter ride-along yesterday. Leading up to yesterday, it looked likely that I would have to be tied to the helicopter in order for me to go, à la “What about Bob?” Luckily for me, I was just settling in when we got our first call around 7:10. This way, I had little time for second thoughts, as before I knew it, I had grabbed my camera, clamored into my seat, adjusted my headset, and became airborne. “Wow!” and “Ahh!” were the words overriding conscious thought. The view was amazing! I figured I might as well enjoy the ride, as I was kind of committed at that point. No one is more surprised than I am that I enjoyed it immensely. Especially as I classify a simple elevator ride as the moment I was most scared in my life. Before 9:30 we had run two calls. The first was an ejection from a vehicle. The patient was basically okay and extremely lucky. The second one was a motorcyclist v. deer. This patient had an obvious facial fracture (I may even go as far as calling it a...

On Friday I had another clinical at the cath lab. This was pretty good. The nurse I was paired with was a little scary at times. But she was a good preceptor and let me do everything. I got my 1st IV (attempt and success) in 5 months which was pretty exciting. I think I was just as nervous starting that one as I was when starting my first one ever. It had been almost too long. I figured that out when I realized that my hands were shaking slightly when I’d finished. That night I went to a Halloween party at my friends house. I went as a crazy cat lady, which consisted of wearing pajamas, putting my hair in haphazard curlers, and safety pinning numerous stuffed cats to my clothes. I tied for best costume with Andy, who kind of cheated because he looks so creepily like napoleon dynamite, it didn’t take much to complete his costume. Last night I was kidnapped by CJ and Ewing. They made me ride in the car blindfolded to go to a mysterious location. They even had me walk into a store like th...

I have been officially offered and accepted a job. It should be cool. I had a clinical for school with the same company and the unit I was on only got three jobs in 12 hours. Let me tell you, there’s nothing like putting in clinical time with a company you are about work for. It’s a little more difficult as all you can think is “In about a week, I could be getting paid for this!” Oh, well. On Friday I had my required physical and lift test. I had to go back to the same creepy clinic where I got my drug test. Every room I went into seemed to be a storage/exam room with stacks of miscellaneous boxes marked with ‘to be filed’ ‘pregnancy tests’ ‘private patient information’ ‘we’re not sure what this is’ and ‘looks important.’ For the lift test I had to lift a 60 pound box onto a shelf a little higher than my waist 10 times, put that same box on a shelf almost as tall as me, then walk around the room with the box (my new best friend) and walk up stairs with it. Of course, I had to be on my...

This morning started with an interesting phone call. It didn’t come up as anyone in my phone book which usually stops me from picking it up. But I looked at the number and it was local from my hometown so I decided to answer. Me: “Hello?” Other end: “Hi, this is officer ____from the Maryland State Police.” My brain: “Holy crap! What did we do?” My heart: “I'm going to start racing now!” Me: “Hi…” Other end: “I’m your preceptor for your MSP aviation ride-alongs.” My brain: “Whew!…wait…Holy crap!” My heart: “I'm going to keep racing!” Me: “Great!” Needless to say I’ve worked out the details of my first cough-helicopter-ahem ride. (don’t tell my parents I’ll be riding a helicopter, and definitely don’t tell me.) I won’t disclose the date yet. But as I’m riding on the trooper in my hometown, it will be hard for my parents to not notice me come home and then go missing for 12 hours. Today I discovered that my trucks' gas gauge is broken. I watched with horror as the g...

I’ve applied for a job. Yes, a job, me. Hard to believe, I know, but a little petty cash never hurt anyone. I’ll be working for a private ambo transport service (snore!) but I only have to work 12 hours every two weeks, so it’s not so bad. I’ve learned so far that the pre-hire process is really annoying. My last job interview was about 5 years ago and for that job; I applied, was interviewed on the spot, my label maker name tag was printed out, and two days later I was happily greeting customers at my first real job. If only it were that easy for this job. I applied and was interviewed the next day (which was nice, giving me less time to back out of it.) Then I’m told they need a pre-hire drug test, a copy of my passport, a picture of me in a zebra costume, a valid blockbuster video card, a physical, and various other things. Now, about this ‘pre-hire drug test.’ Luckily I read the paper that said that* I had to get it within 48 hours of my interview, or they would make me watch my fav...

Yesterday marked the class’ second sojourn to the cadaver lab. Wow, I really forgot how much fun this is! The weather is turning great here (high of 78 today, ooh that makes me all warm and fuzzy inside). Yesterday I was trying to gauge what to wear by looking at the people outside. The first person I saw was wearing capris and a sleeveless shirt. The person right behind her was wearing jeans and a jacket; both looking quite content. How am I supposed to decide what to wear when I see that?! I ended up wearing my scrubs with a sleeveless shirt underneath. We entered the lab and all the memories of last time came rushing back to me. First, the fact that we have to wear a gown, shoe covers, surgical cap, gloves and the optional face mask. Second, the presence of two dead bodies. Well, it’s not so much that I forgot that, just that I forgot how unpleasant it is until you can get acclimated to the cadaver lab environment. We got right into it, reviewing airways, intubation, and the like....

Had my first clinical of the semester yesterday. I was riding with a critical care transport unit. My first call was ‘in house’ moving a patient from the ICU to the angio lab. This was pretty cool, as I got to watch the angiography on his brain. (very generally angiography is when they put radioactive ‘ink’ in the bloodstream and x-ray it to identify problems with your vascular system) I was hoping that the bleed would be really obvious but it turned out to be this tiny little thing that was unnoticeable to anyone normal. My other call of the day was bad yet good; the circumstances tragic, the outcome unknown. (I’ll be watching the paper for the next few days.) For a full account you can rent my diary, but the price has gone up. Yet, somehow I got front row seats to a cut-down IV, chest tube insertion, needle decompression, and later a central line insertion. Even better, I understood nearly every aspect of the patients treatment, including drug therapy. Although I did little to nothin...

Oh, to be learning about heart blocks and types of shock! Sitting outside, armed with calipers and a thick packet of EKG strips, analyzing them until I went blind…those were the days! Gone are the times of intubation races, putting 18 gauges in my friends’ arms, memorizing assessment sheets, drip calculations…alas… Now, I’m stuck at my desk reading about peak load staffing, cream skimming, and economics of scale. What exactly is a public utility model, anyway? I’ve been trying to get ahead in my homework before clinicals officially begin for me next week. Unfortunately, I find some of the work…well, er, not engaging. Yeah, that’s nice. Classes are interesting, amazingly so, but that doesn’t necessarily transfer into homework. But in fact, (don’t tell the management students) I’ve actually learned stuff! And, enjoyed it! Other than that I’ve reacquainted myself with late-night, met a frog, found a kitten, worked the system, and ‘donated blood.’

After learning today of the president’s remarks concerning New Orleans, I decided to do a little research and break my rule of avoiding news. After a little googling, I discovered too much for comfort. It's truly overwhelming. The people affected are on my mind, and I hope that our government can sort this thing out and help in the return to normalcy.

Went kayaking today on the Chesapeake, launching from my roommates house on the bay. We went out for about three hours. I’d kayaked the area before, but this was kopapas first salt water experience. On the way back to the house we thought it would be an easier paddle but somehow it turned out that the waves were doing more harm for us than good. At one point it seemed I had been paddling for 10 straight minutes and hadn’t actually gotten anywhere. But riding the waves or, wakes, rather as there were many large boats enjoying Labor day, was good fun. It was a bit harder to get into my Zen kayaking mode because I had to pay attention to the waves, jet skis, Ewing, jellyfish, excessive sea vegetation, and the relatively constant threat of capsize. The day has rekindled my interest in going surf kayaking. Although I think I would fail spectacularly at it, I’d like to give it a try. As for school, all is going well. Then again, I’ve only had one day’s worth of classes so fa...

The room is back in order with a few additions and a few deletions. Most noticeable addition: kopapa, who just barely doesn’t fit completely under the bed, but I think it’s standable. Yesterday was yet another day when I question why we live on the 3rd floor. (other days include, move-out, the other move-in, and the day we bought the TV.) It’s good to wonder ‘why the top floor?’ to roommates when we’re half way up the stairs with a million pound television, having narrowly escaped death after it threatened to crush us for the 50th time. The day before yesterday I received my official NREMT-I patch, card, and certificate, two of which are currently displayed in my room. I have a few more days to veg before school starts. I’m not sure what I’m going to do with this time. Maybe review ACLS, as our test is coming up, but I doubt it. Maybe reacquaint myself with the ‘gargantuan book of death’ (paramedic textbook), but I doubt it. Maybe I’ll go downtown and take the CRT exam,...

Imagine my excitement, mere hours after my last post and 5 comments, unprecedented! Hours later, even more! Unfortunately, these comments needed editing by me. For those posted by actual people, thanks! Glad you like it, keep reading. As for the others; not so sure about the picking up girls thing, definitely not on the market for HD dish TV, and antioxidants are great, but thanks anyway. As a result of this 'comment spam' I've added word verification to the comments. Apparently this stops non-humans from commenting on the blog. Sorry that this is a pain, but hopefully it will rid me of fake comments.

Although I think that I deserve to be declared officially sane; instead of a stamp, I'll be receiving my official NREMT-I patch very soon! I was looking through my old posts back when national registry and I first met and I found where I declared: “NREMT exams are designed not to test your knowledge of paramedicine, but you're overall mental health.” So true. Luckily, I won't have to pass their tests again for another 9 months! And after that, I'll only have to deal with them every two or three years for the rest of my working life...wait, I'll never be rid of them! That horrifying thought aside, today their website says the best thing it's ever said: "Currently registered with the NREMT*." I'll be back at school on Saturday in the greatest apartment ever to enjoy, a dryer, netflix, rice Krispie treats, a dishwasher, Johnny movies, and great friends (oh yeah, learning and all that too). As for now, I'm going to shoot arrows and enjoy this lo...